Hair, Skin, and Nails PrepU

A young man comes to the clinic with an extremely pruritic rash over his knees and elbows, which has come and gone for several years. It seems to be worse in the winter and improves with some sun exposure. Examination reveals scabbing and crusting with some silvery scales. The nurse also notices small "pits" in the nails. What would account for these findings? a) Psoriasis b) Pityriasis rosea c) Eczema d) Tinea infection

A) Psoriasis Rationale: This is a classic presentation of plaque psoriasis. Eczema is usually over the flexor surfaces and does not scale, whereas psoriasis affects the extensor surfaces. Pityriasis usually is limited to the trunk and proximal extremities. Tinea has a much finer scale associated with it, almost like powder, and is found in dark and most areas.

The nurse is preparing to examine the skin of an adult client with a diagnosis of herpes simplex. The nurse plans to measure the client's symptomatic lesions and measure the size of the client's a) vesicles b) bullae. c) nodules. d) wheals.

A) Vesicles

Connecting the skin to underlying structures is/are the a) sebaceous glands. b) subcutaneous tissue. c) papillae. d) dermis layer.

B) Subcutaneous tissue

A 4-year-old child presents to the health care clinic with circular lesions. Which of the following conditions should the nurse most suspect in this client, based on the configuration of the lesions? a) Multiple nevi b) Tinea corporis c) Herpes simplex d) Tinea versicolor

B) Tinea corporis

Which statement by a client about the skin needs validation by the collection of objective data by the nurse? a) "I experience itchy and dry skin every winter" b) "My port wine birth mark has not gotten any bigger" c) "My feet hurt and are always cold to the touch" d) "I had a small skin cancer removed about 3 years ago"

C) "My feet hurt and are always cold to the touch"

A nurse assesses a client for past history of nail problems. The nurse should ask questions about which of these conditions? A. Vitiligo, hirsutism, vitamin deficiency B. Alopecia, dermatitis, chemotherapy C. Psoriasis, fungal infections, trauma D. Eczema, melanoma, herpes zoster

C. Psoriasis, fungal infections, trauma

While assessing an adult client, the nurse observes an elevated, palpable, solid mass with a circumscribed border that measures 0.75 cm. The nurse documents this as a: A. Papule B. Plaque C. Macule D. Patch

A. Papule

An African American female client visits the clinic. She tells the nurse that she had her ears pierced several weeks ago, and an elevated, irregular, reddened mass has now developed at the ear lobe. The nurse should document a a. cyst. b. keloid. c. lichenification. d. bulla.

B. Keloid Rationale: Nodules and tumors are elevated, solid, palpable masses that extends deeper into dermis than a papule. Nodules are 0.5-2 cm and circumscribed; tumors are greater than 1-2 cm and do not always have sharp borders. Examples of nodules include a keloid

A new mother is concerned that her child occasionally "turns blue." On further questioning, she mentions that this occurs at the child's hands and feet. She does not remember the child's lips turning blue. The mother says that the child is eating and growing well. What should the nurse do? a) Question the validity of the mother's story b) Admit the child to the hospital for further observation. c) Reassure the mother that this is normal d) Obtain an echocardiogram to check for structural heart disease and consult cardiology

C) Reassure the mother that this is normal Rationale: This is an example of peripheral cyanosis, a very common and benign condition that typically occurs when the child is slightly cold and adjusting peripheral circulation to keep the core warm. Without other problems there is no need for further workup. If the lips or other central locations are involved, the nurse must consider other etiologies.

A nurse is instructing a client on how to assess himself for herpes simplex lesions by their configuration. Which configuration should the nurse tell the client to look for? A. Discrete B. Linear C. Clustered D. Annular

C. Clustered

Which area of the body should a nurse inspect for possible loss of skin integrity when performing a skin examination on a female who is obese? A. Upper abdomen B. Anterior chest C. Under the breast D. On the neck

C. Under the breast

The nurse is beginning the examination of the skin of a 25-year-old teacher. She previously visited the office for evaluation of fatigue, weight gain, and hair loss. The previous clinician had a strong suspicion that the client has hypothyroidism. What is the expected moisture and texture of the skin of a client with hypothyroidism? A. Moist and rough B. Moist and smooth C. Dry and smooth D. Dry and rough

D. Dry and rough

An adult male client visits the clinic and tells the nurse that he believes he has athlete's foot. The nurse observes that the client has linear cracks on both feet. The nurse should document the presence of: A. Fissures B. Ulcers C. Erosion D. Scales

A. Fissures

While assessing an adult client, the nurse observes freckles on the client's face. The nurse should document the presence of: A. Papules B. Macules C. Bulla D. Plaques

B. Macules

A nurse is teaching a group of 5th grade children about characteristics of the skin. Which of the following should she mention? Select all that apply. A. Circulates blood throughout the body B. Protects against damage to the body from sunlight. C. Largest organ of the body D. Helps make vitamin D in the body E. Aids in maintaining body temperature F. Involved in digestion of food

B. Protects against damage to the body from sunlight C. Largest organ of the body D. Helps make vitamin D in the body E. Aids in maintaining body temperature

A nurse is preparing a client for a physical examination of his skin, hair, and nails. Which of the following interventions should the nurse implement? Select all that apply. A. Have the client stand for the entire examination B. Wear gloves when palpating lesions C. Use sunlight, if possible, to inspect the skin D. Have the client remove his toupee E. Keep the room door closed F. Ask the client to remove only his shirt

B. Wear gloves when palpating lesions C. Use sunlight, if possible, to inspect the skin D. Have the client remove his toupee E. Keep the room door closed

A golden yellow pigment that is heavily keratinized and is found in subcutaneous fat is called what? a) Melanin b) Carotene c) Deoxyhemoglobin d) Oxyhemoglobin

B) Carotene Rationale: Carotene is a golden yellow pigment that exists in subcutaneous fat and in heavily keratinized areas such as the palms and soles

A nurse receives a report from the shift nurse that a client has new onset of peripheral cyanosis. The nurse recognizes that which of the following is the most likely underlying cause? a) Diabetes mellitus b) Local vasoconstriction c) Cardiopulmonary problem d) Skin Cancer

B) Local vasoconstriction

A nurse in a dermatology clinic cares for an adolescent patient with multiple purulent, fluid-filled lesions on her face, shoulders, back, and chest. What is the most likely medical diagnosis for this patient? a) Cystic acne b) Bullous impetigo c) Chickenpox d) Pustular acne

D) Pustular acne